<?php echo $header; ?>
<?php if ($error_warning) { ?>
<div class="warning"><?php echo $error_warning; ?></div>
<?php } ?>
<?php echo $column_left; ?><?php echo $column_right; ?>
<div id="content"><?php echo $content_top; ?>
  <div class="breadcrumb">
    <?php foreach ($breadcrumbs as $breadcrumb) { ?>
    <?php echo $breadcrumb['separator']; ?><a href="<?php echo $breadcrumb['href']; ?>"><?php echo $breadcrumb['text']; ?></a>
    <?php } ?>
  </div>
  <!-- 礼品券 -->
  <div class="page-header">
  <h1><?php echo $heading_title; ?></h1></div>
  <p><?php echo $text_description; ?></p>
  <form class="form-horizontal" action="<?php echo $action; ?>" method="post" enctype="multipart/form-data">
 <fieldset>
      
      <div class="control-group">
        <label class="control-label"><span class="required">*</span> <?php echo $entry_to_name; ?></label>
        <div class="controls">
        
        <input type="text" name="to_name" value="<?php echo $to_name; ?>" />
          <?php if ($error_to_name) { ?>
          <span class="error"><?php echo $error_to_name; ?></span>
          <?php } ?>
      </div></div>
 
        
        
           <div class="control-group">
        <label class="control-label"> <span class="required">*</span> <?php echo $entry_to_email; ?></label>
        <div class="controls">
        
       
        <input type="text" name="to_email" value="<?php echo $to_email; ?>" />
          <?php if ($error_to_email) { ?>
          <span class="error"><?php echo $error_to_email; ?></span>
          <?php } ?></div></div>
      
       <div class="control-group">
        <label class="control-label">  <span class="required">*</span> <?php echo $entry_from_name; ?></label>
        <div class="controls">
       
        <input type="text" name="from_name" value="<?php echo $from_name; ?>" />
        
          <?php if ($error_from_name) { ?>
          <span class="error"><?php echo $error_from_name; ?></span>
          <?php } ?></div></div>
      
         <div class="control-group">
        <label class="control-label"> <span class="required">*</span> <?php echo $entry_from_email; ?></label>
        <div class="controls">
        
        <input type="text" name="from_email" value="<?php echo $from_email; ?>" />
          <?php if ($error_from_email) { ?>
          <span class="error"><?php echo $error_from_email; ?></span>
          <?php } ?></div></div>
      
      <div class="control-group">
        <label class="control-label">  <span class="required">*</span> <?php echo $entry_theme; ?></label>
        <div class="controls">
       
        <?php foreach ($voucher_themes as $voucher_theme) { ?>
          <?php if ($voucher_theme['voucher_theme_id'] == $voucher_theme_id) { ?>
           <label for="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>" class="radio">
          <input type="radio" name="voucher_theme_id" value="<?php echo $voucher_theme['voucher_theme_id']; ?>" id="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>" checked="checked" />
         <?php echo $voucher_theme['name']; ?></label>
          <?php } else { ?>
          <label for="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>" class="radio">
          <input type="radio" name="voucher_theme_id" value="<?php echo $voucher_theme['voucher_theme_id']; ?>" id="voucher-<?php echo $voucher_theme['voucher_theme_id']; ?>" />
          <?php echo $voucher_theme['name']; ?></label>
          <?php } ?>
          <br />
          <?php } ?>
          <?php if ($error_theme) { ?>
          <span class="error"><?php echo $error_theme; ?></span>
          <?php } ?></div></div>
      
       <div class="control-group">
        <label class="control-label">  <?php echo $entry_message; ?></label>
        <div class="controls">
        
        <textarea class="span4" name="message" cols="40" rows="5"><?php echo $message; ?></textarea></div></div>
      
      <div class="control-group">
        <label class="control-label"> <span class="required">*</span> <?php echo $entry_amount; ?></label>
        <div class="controls">
        
        <input  type="text" name="amount" value="<?php echo $amount; ?>" size="5" />
          <?php if ($error_amount) { ?>
          <span class="error"><?php echo $error_amount; ?></span>
          <?php } ?></div></div>
      
    
    <div class="buttons">
      <div class="well">
        <label class="checkbox">
        <?php if ($agree) { ?>
        <input type="checkbox" name="agree" value="1" checked="checked" />
        <?php } else { ?>
        <input type="checkbox" name="agree" value="1" />
        <?php } ?>
        <?php echo $text_agree; ?>
        </label>
        
      </div><div class="row pull-right">
        <input type="submit" value="<?php echo $button_continue; ?>" class="btn btn-large btn-primary span2" /></div>
    </div>
    
    
    
  
    
    
    </fieldset>
  </form>
  <?php echo $content_bottom; ?></div>
<?php echo $footer; ?>